Year 1_10 - California Department of Developmental … S-1 • List the ... feelings. Communication...

Year 1, Session 10: CO

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10. Communication

Student Resource Guide


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CommunicationS t u d e n t R e s o u r c e G u i d e : S E S S I O N 1 0

Outcomes

When you finish this session, you will be able to:

Active Listening

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• List the reasons for communication.

• Give examples of non-verbal communication.

• Identify modes of communication.

• Describe things that get in the way of an individual being understood.

• Identify ways to support individuals’ communication in their daily routines.

• Describe a method for managing conflict.

• Follow the rules for conflict resolution.

K E Y W O R D S

Key Word Meaning In My Own WordsOne person hears another’s words, figures out what they mean, and responds to the words in his or her own words.

Communication Sharing thoughts, views, and feelings.

Communication Boards

Mode of communication that individuals carry with them.

“I” Statements Talking about a conflict from one’s own point of view.

Modes of Communication

The ways in which thoughts, views and feelings can be expressed.

Non-Verbal Expressing thoughts, views and feelings without using spoken words.

Sign Language The mode of communication used in the deaf community. Sign language combines the use of hand shapes, hand and arm movements, facial expressions, gestures, and body language in a structured and conventional manner to express thoughts, views, and feelings.


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A C T I V I T Y

What Do You Want to Know?

Directions: Think about the topic of this training session. Answer the first two questions in the space provided below. You will come back to this page at the end of the session to answer the last question.

What do you already know about communicating with others and about supporting communication for individuals with disabilities?

What do you want to know about communicating with others and about supporting communication for individuals with disabilities?

To be answered at the end of the session, during review: What have you learned about communicating with others and about supporting communication for individuals with disabilities?

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O p e n i n g S c e n a r i oMatthew is an 8-year-old boy with cerebral palsy. Matthew has trouble talking and being understood when speaking words. In his Individual Program Plan (IPP), Matthew has a goal to use a variety of different ways to communicate. Susan, a DSP in the home where Matthew lives is very fond of Matthew and has been trying to get him to practice talking more. Lately Susan has stopped using Matthew’s picture communication system with him and ignores Matthew when he uses gestures or sign language. Matthew has been trying to ask her for a drink of juice using his picture system. Susan has ignored him, saying to him, “Matthew, you just need to learn to talk.” Matthew tries using the sign he knows for drink. Susan again ignores him saying, “I don’t understand that stuff. Matthew, you really can try to tell me in words.” Matthew is very frustrated and just can’t get the words out. He is very thirsty and angry. He falls to the floor and starts screaming and crying.

Communication

Communication is a very important tool in the DSP toolbox. Good communication will help the DSP

reduce confusion and frustration and improve the quality of life for everyone in the home. Good communication is a vital component to decision making and problem solving. It is the basis for recognizing the needs of the individual and providing high quality support. Knowing how to communicate with simple, clear statements will lead to more

positive interactions with the individuals you support, their families, co-workers, and community members.

This session will enhance the DSP’s skills related to:• Communicating with individuals• Supporting individuals’ communication

with others• Communicating with other team

members, including co-workers and community members

What is Communication?

Communication is about sharing thoughts, views, feelings, needs, and preferences. There are three parts to all communication:

When an individual decides to send a message, the intent is to:• Express something meaningful

to him or her• Achieve a purpose• Share thoughts, views, and

feelings with other people

1. Sender The individual with something to communicate.

2. MessageWhat the individual wishes to communicate.

3. ReceiverThe person towhom the message is given. S-3


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Reasons for Communicating

Why do people communicate with each other? People have many different reasons to communicate during the course of each day. One very important reason for communicating is to gain more control of our lives and to participate in our communities. More specifically, people communicate in order to:

• Give and Get InformationFor the DSP, this could mean giving

information to parents or family members about an individual’s progress or letting the regional center know about an unusual incident. It could mean asking everyone in the program his or her opinion on an activity before deciding what to do. Or you may need to check with the regional center, your administrator, and the family before changing the way in which you approach an IPP objective. For individuals, this could mean asking about the day’s plans, meals, what to wear, or when they want to see their friends. It includes asking questions and offering thoughts, views, or understandings.

• Express FeelingsIndividuals may want you to know

when they have had a great day or when they are feeling bad.

• Solve ProblemsYou may need to communicate with

two individuals at your program to work out problems and to help people solve their own issues.

• Learn New ThingsIndividuals will need to know how

to gain skills, such as oral health and hygiene skills, cooking, taking care of their money, or how to make their needs known.

• Persuade OthersIndividuals may want to have others

do something differently. This could mean choosing clothing different from what was offered. It could mean convincing your supervisor to alter your schedule for a special event.

• Make DecisionsThe DSP communicates with many

people who make decisions that affect individuals in their programs. For instance, when a team is trying to figure out how to address a problem, there might be communication among the staff, the consultants, other programs, and the regional center so the best decision is made.

• Build RelationshipsThe DSP communicates with

community members, neighbors, friends, and the individuals he or she supports. All relationships rely on some form of communication. Individuals use communication skills to get to know other people: find out what they like, what they do, what is important to them, and what the individuals have in common.

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Verbal and Non-Verbal Communication

Verbal CommunicationVerbal communication is the most

common way individuals exchange information. Verbal communication is a complex skill, which requires attending to another person. There are many points at which a breakdown could occur when using verbal communication. Verbal communication can be broken into four parts.1. Organizing the message. This begins

with the thought process of what the individual wishes to say.

2. Sending the message. The individual transfers the thought into spoken words, which are delivered to another person.

3. Receiving the message. The person receiving the message hears the message and attends to it.

4. Processing the message. The brain of the person receiving the message decides what the intended message means.Excerpted from the Caregiver Manual &

Resource Guide for Southwest Florida, Florida Gulf Coast University, 2002.

Non-Verbal CommunicationNon-verbal communication is

communication that is expressed without spoken words. Sometimes a sender’s spoken message is not understood by the receiver. At these times, non-verbal communication may be more effective

since there is less chance for breakdown to occur. Generally the receiver needs to attend to the sender and see the non-verbal communication to understand it. Non-verbal communication can also be used to overcome other barriers to communication, for example difficulty speaking due to cerebral palsy. Following are some examples of non-verbal communication:

• Facial ExpressionsWhat an individual is feeling is

communicated by the look on his or her face. For example, usually a smile means the individual is happy, and a frown means that he or she might be sad.

• GesturesGestures are hand, body, and facial

movements that have meaning. Examples are putting your hands up as if to say “I don’t know,” or shaking your head to say “Yes” or “No,” or waving to an individual in order to say, “Come closer, please.”

• Volume of VoiceThe loudness or softness of a person’s

voice may communicate how they feel.

• Physical Closeness Standing close to people usually

means they know each other well. Most people try to stay about an arm’s length away from the person to whom they are talking.

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Modes of Communication

Now you know that communication can be either verbal or non-verbal. The variety of ways communication can be expressed are called modes of communication. Modes are either verbal or non-verbal.

Common modes of communication include:• Spoken Language

Spoken language uses speech in words and sounds that are conventional and structured. Individuals with intellectual/developmental disabilities may understand spoken language, but not have developed speech skills. They may use speech mixed with other forms of communication to make their needs known.• Written Language

Written language is not always written in full sentences or spelled correctly. It is meaningful communication when the sender and receiver understand the context of the written language. For example, if an individual is in the grocery store and writes the word “cheese,” she or he may wish to buy cheese. However, if the individual is in the kitchen with the refrigerator door open and writes the word “cheese,” this time it may mean, “Help me find the cheese.” • Sign Language

Sign language is the mode of communication used in the deaf community. In the United States, the standard sign language is American Sign Language. It combines the use of hand shapes, hand and arm movements, facial expressions, gestures, and body language in a structured and conventional manner to express thoughts, views, and feelings. American Sign Language has its own alphabet, words, and syntax. The American Sign Language alphabet can be found in Appendix 10-A.

• Sign SystemsSign systems are based on American

Sign Language and have been adapted to the needs of individuals who are in schools and whose learning styles limit their use of spoken language. Many individuals who have developmental delays use signs that combine parts of American Sign Language and local, school, or home-based signs. Appendix 10-B provides a basic list of words in American Sign Language for the DSP to use as a reference tool.• Communication Books

Communication books contain pictures, words, photographs, or symbols. They can be used separately or combined in one book. Individuals who use these books might point to the message they wish to send or use the book in combination with speech or even with signing. Communication books are developed based upon each individual’s needs and abilities.• Communication Boards/Electronic

Devices Communication boards are modes of

communication that individuals carry with them. Some individuals use a board that has letters on it, like a computer keyboard. They point to the letters that spell words so someone can understand them. Some people have electronic systems that use pictures or symbols or that attach to computer monitors. Some systems have a voice that repeats the word, sign, or symbol to which the individual points.• Behavior

Behavior can tell you a lot if you “listen” to what it is saying. Among other things, it gives you information about what individuals want, when they are unhappy, and their interest in being social.

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A C T I V I T Y

“Listening” to What Behaviors Are Communicating

Directions: Read about behaviors described in the left column. In the right column, write down what you think those behaviors are communicating.

What could that behavior Behavior be communicating? Example:Bob points to an apple on the table Bob wants to eat the apple.and then points to his mouth.

Marta smiles and shakes your hand.

Dan comes to you with a toothbrush in one hand, toothpaste in the other hand, and a confused look on his face.

Lisa spits out peas onto the table.

Juan tugs at your sleeve.

Some of the things that behavior can communicate are individuals’:• Preferences or choices• Requests for objects • Requests for assistance • Requests for affection• Desire for attention• Feelings

The purpose of all modes of communication is to support individuals as they make choices and interact. It is important that DSPs are able to identify the modes of communication that individuals use and support them in using those modes.

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Modes of Communication (cont.)


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Communication Disorders

You have learned about some of the ways that people communicate. In part, the mode of communication is influenced by communication disorders that an individual may have. Some of the things that can get in the way of an individual being understood include:• Limited or no speech• Hearing loss• Poor control of muscles needed to

produce speech (like with cerebral palsy)

• Damage to the part of the brain that controls speech

• Challenging behaviors• Day-to-day health of the individual

When making your needs known is hard, it’s difficult to meet people and to do the things you enjoy, and it may make an individual behave in a negative way.

There are two kinds of communication disorders:

1. Speech DisordersSpeech disorders relate to the muscles

that people use to form the sounds of speech. There are four types of speech disorders:

• Abnormal PitchThis is a condition in which an

individual’s voice is high-pitched or very deep. It is similar to the difference between a man’s and a woman’s voice. Men’s voices are usually lower toned or pitched than women’s.

• Abnormal QualityThis is a disorder in which an

individual makes the sounds, but the sounds last longer or shorter than usual or are molded together in a way that make it

hard to understand. It is similar to a tape recording that has gotten too old so that the tape moves slowly or a tape recording that, at the end of the tape, moves fast so the voices sound high pitched and fast.

• Excessive LoudnessThis is a condition in which individuals

almost shout rather than talk in a normal voice.

• Incorrect ArticulationThis is a condition where the

individual’s mouth makes sounds incorrectly. Perhaps a “p” is pronounced with a voice and breathing like a “b” sound. Another example is an individual’s inability to make the sound at all with his or her lips, which keeps the listener wondering what he or she meant.

Sometimes speech muscles that don’t work cause a speech disorder. You may hear a speech therapist who works for someone you support talk about this. Some individuals may miss sounds when they are talking, like saying “nake” for “snake,” or “moke” for “smoke.” Or an individual might say “dis” and “dat” instead of “this” and “that.”

2. Language DisordersLanguage disorders are sometimes

caused by damage to some area of the brain. With a language disorder an individual might be limited in his or her ability to understand language. This is called receptive language. An individual’s ability to talk might be limited. This is called expressive language. Or, a person may talk as if they are much younger.

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Once the DSP has identified the individual’s modes of communicating, his or her responsibility is to encourage communication during daily routines. Each time the DSP and the individual are together is a chance to initiate communication. This will help individuals have more control of their lives and participate in their communities in a meaningful way.

Following are some suggestions for supporting individuals’ communication every day:

• Create opportunities during the day to promote conversations with individuals For example, talk to the individual

while doing personal care, oral hygiene, eating, and dressing routines. These are opportunities for you to learn more about individuals’ modes of communication and their preferences.

• Provide individuals time to respond Sometimes people are so busy that

they ask a question and don’t really wait for a response. How many times have you asked someone “How are you?” without waiting to hear their answer? It is important to keep in mind that some individuals may take longer to understand a question. Others may need time to formulate their response. Sometimes the response may take a very long time.

• Acknowledge the individual’s attempt to communicate Remember that everyone

communicates in different ways. Even a small sound or gesture needs to be noticed. That will let the individual know that what they are trying to tell you is important to you.

• Provide opportunities to make choices. Avoid making decisions for individuals If you have known an individual for a

long time, you often think you know what they need and want. However, individuals’ needs and preferences may change over time. It is essential to create opportunities for individuals to communicate their needs and preferences. One way to do this is to provide “choice opportunities.” Choice opportunities are situations in which someone is provided with a choice between two or more items or activities. You can offer choices throughout the daily routine. For example, “Do you want to brush your teeth with Crest® or Colgate®?” “Do you want pizza or steak for dinner?” “Would you like to go for a walk or go to a movie?”

• Talk to the individual about routines as they occur It is important to talk about activities

as you do them. Imagine if you had to go through a day in total silence. By talking through each activity, you increase the chances that the individual will learn the words, as well as the order of the activities. You should talk through routines with the individuals you support even if you don’t know if they really understand. You don’t always know what the individual understands.

What the DSP teaches about communication is as important as how it is taught. If an individual is communicating through pictures or graphic symbols, the DSP may need to spend more structured time to assure that the symbol used matches what the individual wants to communicate. The DSP can also use those symbols throughout the day for routines and activities so that there are many chances to practice them. For someone who is learning to make choices S-9


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A C T I V I T Y

Supporting Individuals' Communication in Their Daily RoutinesDirections: Think of an individual whom you support and one routine that they do on a daily basis (for example, brushing their teeth, bathing, eating breakfast). Using the Strategies for Making Communication a Part of Every Day and your own strategies, write down three ways that you can encourage that individual’s communication during that routine.

Daily routine:_______________________________________________________

Strategies I use to encourage communication during this routine:

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2.

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through facial expressions, you can also make sure that there are a number of chances for him or her to make a choice and to practice facial expressions.

Strategies for Making Communication a Part of Every Day• Use words when the individual feels

something (sore, hurt, tired).• Name objects during daily routines.• Describe everything as you assist the

individual (dressing, serving meals).• Point to pictures of objects in books

and say them clearly.• Provide time for the individual to

respond/communicate.

• Point out objects while on a walk, in the car, at the park, or in the store.

• Encourage the individual to watch your mouth as you say words.

• Speak in short sentences when giving directions.

• Be sure to pronounce the entire word.• Encourage progress in making sounds

and saying words.• Be sure your movements are simple

when teaching.• Encourage individuals to use all of

their senses.• Listen carefully to what the individual

says or attempts to say.

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Supporting Individuals’ Communications During Daily Routines (cont.)


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Communication with Co-Workers

Until now, this session has focused on communicating with individuals and facilitating individuals’ communication. We will now discuss how DSPs communicate with each other and with other team members.

Active ListeningEach of us shares the responsibility for

good communication. Listening is a key skill to good communication. Realistically the life of a DSP doesn’t always lend itself to those private moments when listening would be easy. When you add more people and their interests, you’ve increased the difficulty of listening. Effective DSPs develop the skills to both assist individuals to communicate and to listen very carefully. Another role of the DSP is to learn how to communicate effectively with other team members, including:• Family members• Regional center staff• Licensing staff• Administrators• Neighbors• Co-workers• Work or program staff

We all need to take the time to figure out the words we hear. We may even need to ask the person who said them if we heard correctly before we respond. That means that we have to pay very close attention to each word the person is saying. This is called active listening because it involves a lot of energy. The steps for active listening are: • Hear the words• Figure out their meaning• Respond to the meaning in your own

words Hearing what a person says is not the

same as listening. It happens when you take time to see if what you understood was what the person really meant. Your response is a way to “check” if the individual or fellow DSP feels heard and that the communication was understood. The ways that the DSP can do this are to:• Ask the speaker questions to see if the

understanding is correct.• Reword the statement and say it back

for clarification. For example: “What I hear you saying is that you feel frustrated. Is that correct?”Sometimes it is important to not only

hear the words but to “actively listen” to the individual’s behavior or other modes of communication.

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ConflictResolution

To this point, this session has focused on assisting individuals learn how to communicate and DSPs becoming good communicators. There will be times, even with good communication, when people disagree. For example, the planning team may disagree about the goal an individual may have, a parent may disagree with the support given to an individual, or two individuals living together can disagree about what TV program to watch. There

are many times that a DSP will encounter conflict. It is important to know how to effectively and professionally resolve conflict.

Helping individuals be more independent may also mean teaching individuals how to resolve conflicts, how to solve their own problems, and how to make decisions. With those skills, the individuals you support can be more confident in their own abilities.

A C T I V I T Y

Stepping into Another Person’s Shoes

Directions: Pair up with another person in the class, and ask the following questions. Write your partner’s answers below.

1. Did you share a bedroom while growing up?

2. Do you share a home with someone now?

3. Was there ever a time when you didn’t like sharing a room?

4. What made sharing a room or a house difficult?

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A C T I V I T Y

ConflictBrainstorm

Directions: Write down all of the words you can think of that mean “conflict” to you.

Conflictis:

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Sometimes what you see as a disagreement is seen very differently by the other person. One important part of understanding conflict is to see things as the other person sees them.

A C T I V I T Y

The Way I See It

Directions: Think about a conflict or disagreement you are currently involved in. It can be in your work life or outside of work. Imagine that right after class, you are meeting with the person with whom you have a conflict. Maybe you had a disagreement last night and have not seen that person since. Prepare for that meeting by writing down your answers to the following questions.

1. What is the disagreement?

2. What will you discuss with the person when you meet?

3. What result do you want from the meeting?

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ConflictResolution(cont.)ConflictResolution(cont.)ConflictResolution(cont.)


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A C T I V I T Y

Another Way to See It

Directions: Now imagine that you are the person with whom you have a conflict. Prepare for that same meeting by writing down your answers to the following questions.

1. What is the disagreement?

2. What will you discuss with the person when you meet?

3. What result do you want from the meeting?

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ConflictResolution(cont.)


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MethodforManagingConflict

Following is a method that you might use for managing conflict. This method may be helpful both at work and at home.

• Separate the person from the problem

Put yourself in the other person’s place, like you just did in the activity. Sometimes, something about the person is just annoying to you. It could be his or her voice or the way he dresses, or you don’t like the way he lives his life. But you have to look just at the problem in order to resolve things. You have to control your emotions, even if the other person is doing things that really bother you. Mostly, you want to make sure that you understand each other.

• Figure out each person’s goals and interestsConcentrate on what each person

wants most and try to find the places where there is agreement. Be open to meeting someone half way. Everyone should define how they see the problem, and the problem has to be discussed before solutions can be found.

• Find answers that work for both peopleThere are many different ways to find

possible answers to the problem. One way is brainstorming, which you’ll practice a little later. Explore all kinds of options before making a decision.

• Try to agreeYou may not come to agreement on

a solution the first time that you discuss the problem. Sometimes, you have to review all of the options several times. Some people may want to think it over or discuss it with others. Once there is agreement, decide what the next steps might be. Who will do what, and when will that be done? Then figure out how to decide if the solution really worked.

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A C T I V I T Y

Brainstorming

Directions: Break into small groups. Read the following scenario. Next, brainstorm some ways that the money could be spent. Every idea that group members suggest must be written down. Then, as a group, try to come to agreement on one of the options.

ScenarioOne of the parents whose child lives in the home where you work just gave you $500. The parent said that the money can be spent in whatever way the whole group decides. The only restriction is that everyone has to be part of the decision making process.

Our group’s ideas for how the money should be spent:

We decided on this idea:

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RulesforConflictResolution

Below are some rules for resolving conflict. Rules like these are often used to help couples to communicate better. When you are discussing a difficult problem:

• Use “I” statementsUsing “I” statements means that

you need to talk about the problem or disagreement from your own point of view. Look at the difference between the following statements:

“I feel much better when you call to let me know you’ll be late.”

“You never come home on time.”

The second example puts the blame for the problem on the other person and can make it difficult to resolve the problem.

• Be willing to resolve the problem

• Do not engage in name calling

• Stay in the present and stick to the topicStaying in the present and sticking to

the topic means that you shouldn’t bring up problems that are not related to what you are discussing right now. Consider the following statements:

“You are acting just how you used to act five years ago when you never called home if you knew you would be late.”

“And I also am sick of you leaving your dirty clothes on the floor instead of putting them in the hamper.”

Statements like these take the focus off the problem at hand and make resolving it seem much less manageable.

• Don’t interrupt the person who is talking

• Recognize that the other person has his or her own feelings

• Ask questions to understand the other person’s side

Spencer Johnson, M.D.

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P R A C T I C E & S H A R E

During this session you learned about modes of communication and communication disorders. Think about an individual whom you support. What modes of communication do they use most often? Do they have any communication disorders? How can you assist them in communicating more effectively?

A C T I V I T Y

ObservingforEffectiveCommunication

Directions: Think about the video. Make a list of the good and bad examples of communication you observed. Think of how the bad examples could have been communicated in a better way. As a group, be prepared to discuss what you observed with the whole class and to make suggestions for improving upon the bad examples.

E F F E C T I V E C O M M U N I C A T I O N

“Good” communication “Bad” communication

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Session 10 Quiz

Communication

1. Why do people communicate?A) To give and get informationB) To stay healthyC) To increase their incomeD) To isolate themselves

2. Verbal communication has four parts: organizing the message, sending the message, receiving the message, and:A) Sending the message backB) Processing the messageC) Repeating the messageD) Forgetting the message

3. Which is an example of nonverbal communication?A) Naming the days of the weekB) Using facial expressions and gestures

to make a requestC) Singing out loud at meal timeD) Talking on a cell phone

4. What is one thing that may get in the way of an individual being understood?A) Television watchingB) Socializing with other individualsC) Having many unmet needsD) An individual’s hearing loss

5. Ways to support communication during daily routines include:A) Not understanding the individual’s

needsB) Creating more opportunities for quiet

timeC) Sitting and speaking with an individual

after dinnerD) Talking only when the individual asks a

question

6. If an individual has poor muscle control, howmightitaffecttheirspeech?A) They may make sounds that are not

clearB) They may not be able to hearC) They may be very loudD) They may only speak when spoken to

7. Which is an example of verbal communication?A) An individual responds “Hello” to a

greetingB) An individual shakes a DSP’s handC) An individual moves away from the

person speaking to himD) An individual is sitting quietly in a chair

8. Whenmanagingconflict,itisimportantto:A) Enforce the rulesB) Separate the person from the problemC) Win your argumentD) Separate people who disagree

9. An “I” statement describes a problem:A) From your own point of viewB) With the individual’s behaviorC) So it is clear who is at faultD) With the individual’s plan

10.Whendiscussingadifficultproblemwith a co-worker:A) Don’t interrupt the person who is talkingB) Be sure to get your own wayC) Bring up similar problems you have

had with the co-worker in the pastD) Try to make the co-worker angrier

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Appendices

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Appendix 10-A

American Sign Language Manual Alphabet(www.lifeprint.com)

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NAppendix 10-B

Saying Words with American Sign Language

Excerpted from Vicars American Sign Language Course Introductory Signing Concepts @ www.lifeprint.com

HomeThe sign for “home” is made by touching your fingers and thumb together at the mouth. Then move your hand from your mouth to your right cheek.

WorkThe sign for “work” is made by shaping both

hands into the letter “s.” With your palms facing downward, tap your left wrist on the

back of your hand a few times with your right wrist.

SchoolThe sign for “school” is made by clapping your hands. Repeat two or three times.

StoreThe sign for “store” is made by bending both

wrists and pointing both hands down. Pivot both of your hands toward and away from

your body. Repeat a few times.

HungryThe sign for “hungry” is made by forming your right hand into the letter “c.” Move your hand down the middle of your chest, starting under your throat. Note: Some people use the sign for “wish,” and prefer to start “hungry” from a slightly lower position.

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Thank YouThe sign for “thank you” is made by touching

your lips with one or both of your hands. Your hand(s) should be flat. Move your hand(s)

away from your face, palms upward. Smile. Note: Most people use only one hand for this

sign.

SadThe sign for “sad” is made by placing both hands in front of your face, palms in. Bring both of your hands down the length of your face. Tilt your head forward slightly, and a make a sad face.

LoveThe sign for “love” is made by crossing both hands over your heart. Your hands may be closed or open, but the palms should face

toward you.

HelpThe sign for “help” is made by closing your right hand. Place your right hand on the outstretched palm of your left hand. Raise both hands. Note: Many people make this sign by placing the left “s” or “a” hand on the right “b” palm.

BathroomThe sign for “bathroom” is made by forming

the right hand into the letter “t.” With your palm facing away from you, shake your hand

in front of your chest.

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Appendix 10-B (cont.)

Year 1_10 - California Department of Developmental … S-1 • List the ... feelings. Communication...

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